U.S. patent application number 14/906651 was filed with the patent office on 2016-06-09 for multi-function mounting interface for an image-guided robotic system and quick release interventional toolset.
The applicant listed for this patent is CENTRE FOR SURGICAL INVENTION & INNOVATION. Invention is credited to Mehran ANVARI, Peter D. BEVAN, Kathryn CHAN, Timothy Scott FIELDING, Steve FISHER, Tej SACHDEV, Andrew P. TURNER.
Application Number | 20160157941 14/906651 |
Document ID | / |
Family ID | 52392534 |
Filed Date | 2016-06-09 |
United States Patent
Application |
20160157941 |
Kind Code |
A1 |
ANVARI; Mehran ; et
al. |
June 9, 2016 |
MULTI-FUNCTION MOUNTING INTERFACE FOR AN IMAGE-GUIDED ROBOTIC
SYSTEM AND QUICK RELEASE INTERVENTIONAL TOOLSET
Abstract
Tool mount adaptors for interfacing a medical instrument with a
medical insertion device are provided. The tool mount adaptor
includes a collar for holding a medical instrument wherein the tool
mount adaptor is releasably attachable to the medical insertion
device. Cannula holder assemblies for a medical insertion device
are also provided. The cannula holder assembly includes: (a) a
cannula track; and (b) a cannula carriage slideably mounted on the
cannula track comprising a cannula holder mount and a demobilizer.
Medical insertion devices comprising the tool mount adaptors and/or
cannula holder assemblies are also provided together with methods
of using the medical insertion devices in diagnostic and/or
therapeutic applications.
Inventors: |
ANVARI; Mehran; (Hamilton,
CA) ; BEVAN; Peter D.; (Toronto, CA) ; FISHER;
Steve; (Schomberg, CA) ; TURNER; Andrew P.;
(Mississauga, CA) ; SACHDEV; Tej; (Milton, CA)
; FIELDING; Timothy Scott; (Mississauga, CA) ;
CHAN; Kathryn; (Toronto, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
CENTRE FOR SURGICAL INVENTION & INNOVATION |
East Hamilton |
|
CA |
|
|
Family ID: |
52392534 |
Appl. No.: |
14/906651 |
Filed: |
July 24, 2014 |
PCT Filed: |
July 24, 2014 |
PCT NO: |
PCT/CA2014/000591 |
371 Date: |
January 21, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61857917 |
Jul 24, 2013 |
|
|
|
Current U.S.
Class: |
606/130 ; 248/70;
279/143 |
Current CPC
Class: |
A61B 2017/00477
20130101; A61B 34/70 20160201; A61B 10/0283 20130101; A61B 34/30
20160201 |
International
Class: |
A61B 34/30 20060101
A61B034/30; A61B 34/00 20060101 A61B034/00 |
Claims
1. A tool mount adaptor for interfacing a medical instrument with a
medical insertion device, the tool mount adaptor comprising a
collar for holding a medical instrument, wherein the tool mount
adaptor is releasably attachable to the medical insertion
device.
2. The tool mount adaptor of claim 1, wherein the collar comprises
a first piece and a second piece, wherein the first piece and the
second piece are releasably connectable to form the collar.
3. The tool mount adaptor of claim 2, wherein a first end of the
first piece is releasably connectable with a first end of the
second piece and a second end of the first piece is releasably
connectable with a second end of the second piece to form the
collar.
4. The tool mount adaptor of claim 1, which further comprises a
locking mechanism, wherein the locking mechanism is adapted to
restrict separation of the first piece and the second piece when in
a locked mode and allow separation of the first piece and the
second piece when in an unlocked mode.
5. The tool mount adaptor of claim 4, which further comprises a
locking mechanism, wherein: when in a locked mode, the locking
mechanism restricts separation of the first piece and the second
piece and restricts detachment of the tool mount adaptor from the
medical insertion device; and when in an unlocked mode, the locking
mechanism allows separation of the first piece and the second piece
and allows detachment of the tool mount adaptor from the medical
insertion device.
6. The tool mount adaptor of claim 1, wherein the medical insertion
device comprises lateral receiving members and the collar comprises
engaging members adapted to engage the receiving members.
7. The tool mount adaptor of claim 6, wherein the receiving members
define apertures and wherein the engaging members comprise a nub
complementary to the apertures.
8. A cannula holder assembly for a medical insertion device
comprising: (a) a cannula track; and (b) a cannula carriage
slideably mounted on the cannula track comprising a cannula holder
mount and a demobilizer, wherein the demobilizer in a
demobilization mode is adapted to restrict movement of the cannula
carriage along the cannula track and in a mobilization mode allows
movement of the cannula carriage along the cannula track.
9. The cannula holder assembly of claim 8, wherein the cannula
track comprises a first set of teeth and the demobilizer comprises
a first pawl adapted to engage the first set of teeth.
10. The cannula holder assembly of claim 9, wherein the demobilizer
comprises a first lever adapted to disengage the first pawl.
11. The cannula holder assembly of claim 9, wherein the cannula
track comprises a second set of teeth and the demobilizer comprises
a second pawl adapted to engage the second set of teeth.
12. The cannula holder assembly of claim 11, wherein the
demobilizer comprises a second lever adapted to disengage the
second pawl.
13. The cannula holder assembly of claim 9, comprising a toggle for
disengaging the first pawl when the second pawl is disengaged, and
the second pawl when the first pawl is disengaged.
14. The cannula holder assembly of claim 8, wherein the cannula
carriage further comprises a cannula holder for receiving a
cannula, the cannula holder being releasably attachable to the
cannula holder mount.
15. A medical insertion device comprising: (a) a frame; and (b) a
carriage assembly connected to the frame comprising: (i) a mounting
arm comprising an insertion track; (ii) an insertion carriage
adapted to move along the insertion track; and (iii) a tool mount
adaptor connected to the insertion carriage, the tool mount adaptor
comprising a collar for a medical instrument, wherein the tool
mount adaptor is releasably attachable to the insertion
carriage.
16. The medical insertion device of claim 15, which further
comprises a linear slide assembly connected to the frame, wherein
the carriage assembly is connected to the frame by way of the
linear slide assembly, and the carriage assembly is adapted to move
along the linear slide assembly.
17. The medical insertion device of claim 16, which further
comprises a rotary drive assembly for driving the linear drive
assembly.
18. The medical insertion device of claim 15, wherein the insertion
carriage comprises a motor to propel the insertion carriage along
the insertion track.
19. The medical insertion device of claim 15, wherein: the mounting
arm of the carriage assembly further comprises a cannula track
parallel to the insertion track; the carriage assembly further
comprises a cannula carriage, the cannula carriage comprising a
demobilizer and a cannula holder mount for receiving a cannula, and
the cannula carriage is adapted to move along the cannula track;
and the demobilizer in a demobilization mode is adapted to restrict
movement of the cannula carriage along the cannula track and in a
mobilization mode allows movement of the cannula carriage along the
cannula track.
20. The medical insertion device of claim 19, wherein the insertion
carriage includes a demobilizer-disengaging member adapted to set
the demobilizer to a mobilization mode.
21. A method for facilitating insertion of a medical instrument in
a patient using a medical insertion device, the medical insertion
device comprising: (a) a frame; and (b) a carriage assembly
connected to the frame comprising: (i) a mounting arm comprising:
(1) an insertion track; and (2) a cannula track parallel to the
insertion track; (ii) an insertion carriage adapted to move along
the insertion track; and (iii) a tool mount adaptor connected to
the insertion carriage, the tool mount adaptor comprising a collar
for holding a medical instrument, wherein the tool mount adaptor is
releasably attachable to the insertion carriage; and (iv) a cannula
carriage adapted to move along the cannula track, the cannula
carriage comprising: (1) a demobilizer, wherein the demobilizer in
a demobilization mode is adapted to restrict movement of the
cannula carriage along the cannula track and in a mobilization mode
allows movement of the cannula carriage along the cannula track;
and (2) a cannula holder mount for receiving a cannula, the method
comprising: (A) securing a medical instrument in the collar of the
tool mount adaptor and moving the insertion carriage along the
insertion track in an insertion direction to insert the medical
instrument into the patient; or (B) moving the insertion carriage
along the insertion track in a direction opposite to the insertion
direction to retract the medical instrument from the patient and
optionally removing the medical instrument from the collar; or (C)
securing a medical instrument in the collar of the tool mount
adaptor, moving the insertion carriage along the insertion track in
an insertion direction to insert the medical instrument into the
patient, actuating at least one functionality of the medical
instrument held within the tool mount adaptor, moving the insertion
carriage along the insertion track in a direction opposite to the
insertion direction to retract the medical instrument from the
patient and optionally removing the medical instrument from the
collar; or (D) securing a cannula to the cannula holder mount and
moving the cannula carriage along the cannula track in the
insertion direction to insert the cannula into the patient; or (E)
moving the cannula carriage along the cannula track in a direction
opposite to the insertion direction to retract the cannula from the
patient and optionally removing the cannula from the cannula holder
mount; or (F) securing a cannula to the cannula holder mount,
moving the cannula carriage along the cannula track in the
insertion direction to insert the cannula into the patient, moving
the cannula carriage along the cannula track in a direction
opposite to the insertion direction to retract the cannula from the
patient and optionally removing the cannula from the cannula holder
mount; or (G) actuating at least one functionality of the medical
instrument held within the tool mount adaptor; or (H) any
combination of steps A, B, C, D, E, F and G, or any combination of
any subset of steps A, B, C, D, E, F and G, performed in any order
where any one of steps A, B, C, D, E, F and G is performed one or
more times.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Patent Application Ser. No. 61/857,917 entitled "MULTI-FUNCTION
MOUNTING INTERFACE FOR AN IMAGE-GUIDED ROBOTIC SYSTEM AND QUICK
RELEASE INTERVENTIONAL TOOLSET" filed on Jul. 24, 2013, which is
incorporated herein by reference in its entirety.
FIELD OF INVENTION
[0002] This invention relates to surgical robotics, and in
particular the control of medical instruments which have an
insertion action, such as a biopsy needle or ablation tool.
BACKGROUND
[0003] Cancer diagnosis and treatment can require the medical
practitioner to be able to pin point a suspicious lesion within the
patient. After the area is located, the next step in a typical
treatment process can include a biopsy procedure to identify the
pathology, which can be performed in the operating room, with the
patient under general anesthetic. In other instances, biopsy
procedures can include the implementation of core needle biopsy
procedures using minimally invasive core needle extraction
methods.
[0004] Difficulties can arise in performing a conventional
procedure. As an example, for breast biopsy with magnetic resonance
imaging (MRI) systems, the patient may have to be shuttled in and
out of the magnet several times before a biopsy is actually
performed. During this time, the contrast agent could have already
lost some of its effect and image quality could suffer. This
process itself may be time consuming and cumbersome, especially in
a time-sensitive environment.
[0005] In addition, contrast laden blood from a hematoma as well as
an air pocket at the biopsy site can make it difficult to
subsequently verify that the correct site identified from the
imaging system was biopsied, or to rapidly confirm that the sample
obtained has a suspect morphology. This practice could also require
removal of a relatively large volume of tissue, with a fraction of
that assumed to be from the lesion.
[0006] In order to retrieve tissue for diagnosis or treatment,
medical technology has advanced to the point that medical
instruments can be inserted into a body toward a suspected lesion.
The insertion procedure can be made more useful if it is adapted to
accommodate a variety of medical instruments in a safe and
minimally invasive manner.
SUMMARY
[0007] According to an embodiment, there is provided a tool mount
adaptor for interfacing a medical instrument with a medical
insertion device, the tool mount adaptor comprising a collar for
holding a medical instrument, wherein the tool mount adaptor is
releasably attachable to the medical insertion device. In some
embodiments, the collar comprises a first piece and a second piece,
wherein the first piece and the second piece are releasably
connectable to form the collar. In other embodiments, a first end
of the first piece is releasably connectable with a first end of
the second piece and a second end of the first piece is releasably
connectable with a second end of the second piece to form the
collar. In further embodiments, the tool mount adaptor further
comprises a locking mechanism, wherein the locking mechanism is
adapted to restrict separation of the first piece and the second
piece when in a locked mode and allow separation of the first piece
and the second piece when in an unlocked mode. In other
embodiments, the tool mount adaptor further comprises a locking
mechanism, wherein: when in a locked mode, the locking mechanism
restricts separation of the first piece and the second piece and
restricts detachment of the tool mount adaptor from the medical
insertion device; and when in an unlocked mode, the locking
mechanism allows separation of the first piece and the second piece
and allows detachment of the tool mount adaptor from the medical
insertion device. In other embodiments, the tool mount adaptor is
attached to the medical insertion device by way of an end effector
interface and the tool mount adaptor further comprises a locking
mechanism, wherein: when in a locked mode, the locking mechanism
restricts separation of the first piece and the second piece and
restricts detachment of the tool mount adaptor from the end
effector interface; and when in an unlocked mode, the locking
mechanism allows separation of the first piece and the second piece
and allows detachment of the tool mount adaptor from the end
effector interface. In other embodiments of the tool mount adaptor,
the medical insertion device comprises lateral receiving members
and the collar comprises engaging members adapted to engage the
receiving members. In further embodiments of the tool mount
adaptor, the receiving members define apertures and the engaging
members comprise a nub complementary to the apertures. In other
embodiments, the tool mount adaptor is attached to the medical
insertion device by way of an end effector interface and the end
effector interface comprises lateral receiving members and the
collar comprises engaging members adapted to engage the receiving
members. In further embodiments of the tool mount adaptor, the
receiving members define apertures and the engaging members
comprise a nub complementary to the apertures. In some embodiments,
the tool mount adaptor may further comprise a latch to secure the
medical instrument to the collar. In other embodiments, the tool
mount adaptor further comprises a tool interface feature formed
along an interior surface of the collar, wherein the tool interface
feature is adapted to fit an outer surface of the medical
instrument held in the collar. In other embodiments, the tool mount
adaptor further comprises a tool interface feature placed along an
interior surface of the collar, wherein the tool interface feature
is adapted to fit an outer surface of the medical instrument held
in the collar. In other embodiments, the tool mount adaptor further
comprises a demobilizer-disengaging member. In alternative
embodiments, the tool mount adaptor is adapted to attach to the
medical insertion device lateral to an axis of insertion direction
of the medical instrument.
[0008] According to another embodiment, there is provided a cannula
holder assembly for a medical insertion device comprising: (a) a
cannula track; and (b) a cannula carriage slideably mounted on the
cannula track comprising a cannula holder mount and a demobilizer,
wherein the demobilizer in a demobilization mode is adapted to
restrict movement of the cannula carriage along the cannula track
and in a mobilization mode allows movement of the cannula carriage
along the cannula track. In other embodiments, the cannula track
comprises a first set of teeth and the demobilizer comprises a
first pawl adapted to engage the first set of teeth. In further
embodiments, the demobilizer comprises a first lever adapted to
disengage the first pawl. In some embodiments, the cannula track
comprises a second set of teeth and the demobilizer comprises a
second pawl adapted to engage the second set of teeth. In
alternative embodiments, the demobilizer comprises a second lever
adapted to disengage the second pawl. In further embodiments, the
cannula holder assembly further comprises a toggle for disengaging
the first pawl when the second pawl is disengaged, and the second
pawl when the first pawl is disengaged. In other embodiments, the
cannula carriage further comprises a cannula holder for receiving a
cannula, the cannula holder being releasably attachable to the
cannula holder mount.
[0009] According to a further embodiment, there is provided a
medical insertion device comprising: (a) a frame; and (b) a
carriage assembly connected to the frame comprising: (i) a mounting
arm comprising an insertion track; (ii) an insertion carriage
adapted to move along the insertion track; and (iii) a tool mount
adaptor connected to the insertion carriage, the tool mount adaptor
comprising a collar for a medical instrument, wherein the tool
mount adaptor is releasably attachable to the insertion carriage.
In other embodiments, the medical insertion device further
comprises a linear slide assembly connected to the frame, wherein
the carriage assembly is connected to the frame by way of the
linear slide assembly, and the carriage assembly is adapted to move
along the linear slide assembly. In some embodiments, the medical
insertion device further comprises a rotary drive assembly for
driving the linear drive assembly. In alternative embodiments, the
insertion carriage comprises a motor to propel the insertion
carriage along the insertion track. In some embodiments, the
mounting arm of the carriage assembly further comprises a cannula
track parallel to the insertion track; the carriage assembly
further comprises a cannula carriage, the cannula carriage
comprising a demobilizer and a cannula holder mount for receiving a
cannula, and the cannula carriage is adapted to move along the
cannula track; and the demobilizer in a demobilization mode is
adapted to restrict movement of the cannula carriage along the
cannula track and in a mobilization mode allows movement of the
cannula carriage along the cannula track. In other embodiments, the
insertion carriage includes a demobilizer-disengaging member
adapted to set the demobilizer to a mobilization mode. In further
embodiments, the medical instrument connected to the insertion
carriage is adapted to work cooperatively with the cannula
connected to the cannula carriage. In other embodiments, the
medical insertion device interfaces with the tool mount adaptor so
that an off-the-shelf tool or a custom tool is aligned with a known
trajectory. In further embodiments, the medical insertion device
interfaces with the tool mount adaptor to actuate at least one
functionality of the medical instrument. In some embodiments, the
at least one functionality is a trocar functionality, a syringe
functionality, a needle functionality, a fibreoptic sensing
functionality, an interstitial imaging device functionality, a
biopsy tool functionality, a probing functionality or an ablative
tool functionality. In some embodiments, the at least one
functionality is a tool rolling functionality. In other
embodiments, the at least one functionality is an injection
functionality.
[0010] According to another embodiment, there is provided a method
for facilitating insertion of a medical instrument in a patient
using a medical insertion device, the medical insertion device
comprising: (a) a frame; and (b) a carriage assembly connected to
the frame comprising: (i) a mounting arm comprising: (1) an
insertion track; and (2) a cannula track parallel to the insertion
track; (ii) an insertion carriage adapted to move along the
insertion track; and (iii) a tool mount adaptor connected to the
insertion carriage, the tool mount adaptor comprising a collar for
holding a medical instrument, wherein the tool mount adaptor is
releasably attachable to the insertion carriage; and (iv) a cannula
carriage adapted to move along the cannula track, the cannula
carriage comprising: (1) a demobilizer, wherein the demobilizer in
a demobilization mode is adapted to restrict movement of the
cannula carriage along the cannula track and in a mobilization mode
allows movement of the cannula carriage along the cannula track;
and (2) a cannula holder mount for receiving a cannula, the method
comprising: (A) securing a medical instrument in the collar of the
tool mount adaptor and moving the insertion carriage along the
insertion track in an insertion direction to insert the medical
instrument into the patient; or (B) moving the insertion carriage
along the insertion track in a direction opposite to the insertion
direction to retract the medical instrument from the patient and
optionally removing the medical instrument from the collar; or (C)
securing a medical instrument in the collar of the tool mount
adaptor, moving the insertion carriage along the insertion track in
an insertion direction to insert the medical instrument into the
patient, actuating at least one functionality of the medical
instrument held within the tool mount adaptor, moving the insertion
carriage along the insertion track in a direction opposite to the
insertion direction to retract the medical instrument from the
patient and optionally removing the medical instrument from the
collar; or (D) securing a cannula to the cannula holder mount and
moving the cannula carriage along the cannula track in the
insertion direction to insert the cannula into the patient; or (E)
moving the cannula carriage along the cannula track in a direction
opposite to the insertion direction to retract the cannula from the
patient and optionally removing the cannula from the cannula holder
mount; or (F) securing a cannula to the cannula holder mount,
moving the cannula carriage along the cannula track in the
insertion direction to insert the cannula into the patient, moving
the cannula carriage along the cannula track in a direction
opposite to the insertion direction to retract the cannula from the
patient and optionally removing the cannula from the cannula holder
mount; (G) actuating at least one functionality of the medical
instrument held within the tool mount adaptor; or (H) any
combination of steps A, B, C, D, E, F and G, or any combination of
any subset of steps A, B, C, D, E, F and G, performed in any order
where any one of steps A, B, C, D, E, F and G is performed one or
more times. In other embodiments, any one of steps A, B, C, D, E, F
and G is performed one time, two times, three times, four times,
five times, six times, seven times, eight times, nine times or ten
times. In further embodiments, any one of steps A, B, C and G is
performed one or more times wherein the medical instrument is any
one of a trocar, a syringe, a needle, a fibreoptic sensor, an
interstitial imaging device, a biopsy tool, a probe and an ablative
tool. In other embodiments, the same or a different medical
instrument can be used for each of steps A, B, C and G. In further
embodiments, the same or a different medical instrument can be used
for each step A, for each step B, for each step C and for each step
G when any one of steps A, B, C and G is performed two or more
times. In some embodiments, the method comprises step C wherein the
medical instrument is a trocar, a syringe, a needle, a fibreoptic
sensor, an interstitial imaging device, a biopsy tool, a probe or
an ablative tool and the medical instrument is removed from the
collar after retracting the medical instrument from the patient. In
further embodiments, the method comprises step C wherein the at
least one functionality is a trocar functionality, a syringe
functionality, a needle functionality, a fibreoptic sensing
functionality, an interstitial imaging device functionality, a
biopsy tool functionality, a probing functionality or an ablative
tool functionality. In some embodiments, the method comprises step
G wherein the at least one functionality is a trocar functionality,
a syringe functionality, a needle functionality, a fibreoptic
sensing functionality, an interstitial imaging device
functionality, a biopsy tool functionality, a probing functionality
or an ablative tool functionality. In some embodiments, the at
least one functionality is a tool rolling functionality. In other
embodiments, the at least one functionality is an injection
functionality. In other embodiments, the method comprises step F
wherein the cannula is removed from the cannula holder mount after
retracting the cannula from the patient. In some embodiments, the
method comprises securing an anesthesia tool in the collar, moving
the insertion carriage along the insertion track in an insertion
direction to insert the anesthesia tool into the patient, moving
the insertion carriage along the insertion track in a direction
opposite to the insertion direction to retract the anesthesia tool
from the patient and removing the anesthesia tool from the collar;
securing a trocar in the collar and moving the insertion carriage
along the insertion track in an insertion direction to insert the
trocar into a single access point of a patient; securing a cannula
to the cannula holder mount and moving the cannula carriage along
the cannula track in the insertion direction to insert the cannula
into the single access point of the patient; moving the insertion
carriage along the insertion track in a direction opposite to the
insertion direction to retract the trocar from the patient and
removing the trocar from the collar; securing a vacuum assisted
biopsy tool to the collar and moving the insertion carriage along
the insertion track in the insertion direction to insert the vacuum
assisted biopsy tool into the single access point of the patient
and through a hollow body of the cannula; moving the insertion
carriage along the insertion track in a direction opposite to the
insertion direction to retract the vacuum assisted biopsy tool from
the patient and removing the vacuum assisted biopsy tool from the
collar; and moving the cannula carriage along the cannula track in
a direction opposite to the insertion direction to retract the
cannula from the patient and removing the cannula from the cannula
holder mount.
[0011] In some embodiments, the medical instrument is a
needle-based diagnostic or therapeutic device. In other
embodiments, the medical instrument is a trocar, a syringe, a
needle, a fibreoptic sensor, an interstitial imaging device, a
biopsy tool, a probe, an ablative tool or a cannula. In other
embodiments, the medical instrument is a trocar, a syringe, a
needle, a fibreoptic sensor, an interstitial imaging device, a
biopsy tool, a probe or an ablative tool. In some embodiments, the
medical instrument is a trocar, a syringe, or a biopsy instrument.
In some embodiments, the medical instrument is a cutting tool. For
example, the medical instrument is a trocar. In further
embodiments, the medical instrument is an anesthesia tool. For
example, the medical instrument is a syringe. In other embodiments,
the medical instrument is an off-the-shelf syringe. In further
embodiments, the medical instrument is a biopsy tool. For example,
the medical instrument is a vacuum assisted biopsy tool. In other
embodiments, the medical instrument is an off-the-shelf biopsy
tool. In another embodiment, the medical instrument is an ablative
tool. For example, the medical instrument is a radiofrequency
ablation tool, a focused ultrasound instrument, a cryotherapy tool
or a laser. In some embodiments, the medical instrument is a
detector. For example, the medical instrument is a probe or an MRI
coil. In other embodiments, the medical instrument is an ultrasound
probe or a fiber optic probe. In some embodiments, the medical
instrument is an MRI coil. In some embodiments, the medical
instrument may include one or more end effectors.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] Embodiments of the invention are illustrated in the figures
of the accompanying drawings, which are meant to be exemplary and
not limiting.
[0013] FIG. 1 is a perspective view of a medical insertion device
in accordance with embodiments of the present invention.
[0014] FIG. 2 is a perspective view of a medical insertion device
according to various embodiments of the invention.
[0015] FIG. 3 is a perspective view of an end effector assembly
isolated from the medical insertion device of FIG. 2, according to
various embodiments of the invention.
[0016] FIG. 4 is an exploded view of the end effector assembly
shown in FIG. 3.
[0017] FIG. 5 is a perspective view showing some components of a
cannula holder assembly isolated from the medical insertion device
of FIG. 2, according to various embodiments of the invention.
[0018] FIG. 6 is a perspective view showing the end effector
assembly of FIG. 3 according to various embodiments of the
invention.
[0019] FIGS. 7A and 7B are views from the underside of the end
effector assembly of FIG. 3 showing locked and unlocked positions
of a movement locking mechanism.
[0020] FIG. 8 is a perspective view of a cannula holder to be
coupled to a cannula holder mount according to various embodiments
of the invention.
[0021] FIG. 9 is another perspective view of a cannula holder to be
coupled to a cannula holder mount according to various embodiments
of the invention.
[0022] FIG. 10 is a side view of a cannula holder to be coupled to
a cannula holder mount according to various embodiments of the
invention.
[0023] FIG. 11 is a perspective view showing a cannula holder
coupled to a cannula holder mount according to various embodiments
of the invention.
[0024] FIGS. 12A, 12B and 12C are perspective views showing
insertion and locked positions of a cannula in the cannula holder
shown in FIG. 8.
[0025] FIG. 13 is a perspective view of a tool mount adaptor
according to embodiments of the present invention.
[0026] FIG. 14 is an exploded view of the tool mount adaptor shown
in FIG. 13.
[0027] FIGS. 15A, 15B and 15C show various medical instruments
secured by a tool mount adaptor according to various embodiments of
the invention.
[0028] FIG. 16 is a perspective view showing a tool mount adaptor
securing a medical instrument and showing the relationship of a
tool mount adaptor with an end effector interface according to some
embodiments of the invention.
[0029] FIG. 17 is a perspective view showing a tool mount adaptor
secured to an end effector interface according to some embodiments
of the invention.
[0030] FIGS. 18 and 19 are perspective views depicting an
anesthesia tool attached to a collar of a tool mount adaptor
according to various embodiments of the present invention.
[0031] FIGS. 20 and 21 are perspective views showing the tool mount
adaptor shown in FIGS. 18 and 19 without the anesthesia tool.
[0032] FIG. 22 is a planar view of an anesthesia tool attached to
the collar of the tool mount adaptor shown in FIG. 19.
[0033] FIG. 23 is a perspective view depicting a vacuum assisted
biopsy (VAB) tool attached to a collar of the tool mount adaptor
according to an embodiment of the present invention.
[0034] FIG. 24 is a perspective view depicting the tool mount
adaptor shown in FIG. 23.
[0035] FIG. 25 is an exploded view of the tool mount adaptor shown
in FIG. 23.
[0036] FIGS. 26A and 26B are perspective views showing a needle
guide according to embodiments of the invention.
[0037] FIG. 27 is a perspective view showing a needle guide coupled
to a cannula holder according to various embodiments of the
invention.
DETAILED DESCRIPTION
[0038] For a more complete understanding of the present invention,
reference is now made to the following description and accompanying
drawings, which individually and together illustrate embodiments in
which the invention may be practiced. These embodiments may be
combined and elements may be changed, as would be obvious to
persons skilled in the art, without departing from the scope of the
invention.
[0039] Reference is now made to FIG. 1, which shows medical
insertion device 100 in accordance with some embodiments of the
present invention. Generally, medical insertion device 100 can be
used in conjunction with an imaging system (not shown here), such
as a magnetic resonance imaging (MRI) system, when the imaging
system is in use.
[0040] Medical insertion device 100 can include frame 104, which
can at least partially form a housing of medical insertion device
100. Medical insertion device 100 further includes linear slide
assembly 106 mounted or connected to frame 104. Medical insertion
device 100 further includes rotary drive assembly 108 for generally
driving the linear slide assembly 106, and a carriage assembly 110
for moving along the linear slide assembly 106.
[0041] Frame 104 can include a baseplate 112 and a drive support
plate 114 connected thereto to at least partially form a housing of
medical insertion device 100. In an embodiment, the frame can
include a wall(s), such as a front wall, side walls, a back wall, a
top cover, and a bottom wall for protecting components of the
medical insertion device, such as from dust or from a patient's
bodily fluids, or for strengthening the structure of medical
insertion device as required or desired. Frame 104 can also include
drive plate strengthening brackets (not shown) for strengthening
the connection between baseplate 112 and drive support plate 114 as
required or desired. The front wall can define an opening for
operation of components of the invention, as described further
below.
[0042] In further embodiments, the frame can be integrated into or
forms part of a frame that houses (not shown here) the imaging
system (not shown here) with which medical insertion device
interacts. The frame can be panel-shaped to fit within restricted
environments having a limited height. The medical insertion device
can be designed to act cooperatively with an imaging device
according to various embodiments of the invention. For example, it
can be sized to fit underneath the headrest of a patient support
structure that maintains the patient in a face-down position for
MRI breast imaging. This is an additional constraint on the space
requirements imposed by MRI environment, including, but not limited
to, the size and shape of the MRI patient bed and the dimensions of
the MRI bore.
[0043] Linear slide assembly 106 can be connected to frame 104 at
baseplate 112. The linear slide assembly can be connected to the
frame by any means known in the art, such as welding, bolting, or
riveting.
[0044] The medical insertion device can support, control and drive
a medical instrument and/or a cannula as described further below.
The medical insertion device can generally be used to retain,
position, and effect insertion of the medical instrument and/or
cannula into a patient. The medical insertion device can generally
provide a variety of degrees of freedom, including linear, angular
and/or rotational degrees of freedom, for positioning the medical
instrument and/or the cannula prior to insertion of the medical
instrument and/or the cannula into the patient. A tool mount
adaptor may be coupled to the medical insertion device to secure
the medical instrument to the medical insertion device. The medical
insertion device can also include a sensor(s), such as a force
sensor(s), for detecting the tissue being penetrated and for
preventing accidental excursion into an incorrect tissue, such as a
chest wall. The linear slide assembly can function to position
and/or orient the medical instrument and/or cannula for insertion
into a patient.
[0045] With reference to FIG. 1, medical insertion device 100 can
further include a rotary drive assembly 108 mounted to drive
support plate 114 for generally driving linear slide assembly 106,
and a carriage assembly 110 for moving along linear slide assembly
106. Rotary drive assembly 108 can drive linear slide assembly 106
to different positions and configurations, thereby orienting
medical instrument 102 and/or cannula 103 for insertion into a
patient. The linear slide assembly can also be driven by direct
linear drives attached directly to the slide assembly. This could
be done with piezoelectric motors actuated against a linear slide
assembly mounted to the frame or medical insertion device housing.
Other means of operating the linear slide assembly would be readily
apparent to the skilled person.
[0046] A carriage assembly can generally support and control a
cannula carriage according to various embodiments of the invention,
as described further below. With reference to FIG. 1, carriage
assembly 110 can include elongate mounting arm 120, wherein
mounting arm 120 includes an insertion track 122, which runs along
a length of the mounting arm 120. Carriage assembly 110 can further
comprise insertion carriage 124, which can be slideably mounted to
insertion track 122. Insertion carriage 124 can include a mechanism
(not shown) which can propel insertion carriage 124 along the
insertion track 122. The mechanism can be any suitable mechanism
known in the art, such as a pneumatic or piezoelectric motor, if
MRI compatibility is required, or an inductive, or other similar
electric, motor. Generally, movement of insertion carriage 124
along insertion track 122 can cause medical instrument 102 to move
along insertion axis 127.
[0047] In the example shown, insertion track 122 can define
insertion direction 127. In some example embodiments, components of
the carriage assembly can include a force sensor(s) to detect the
tissue being penetrated, and for prevention of accidental excursion
into the incorrect tissue (e.g. a chest wall). In some embodiments,
the alignment of the insertion axis can be confirmed before
insertion via fiducial targets mounted either on the medical
insertion device 100 or on the attached medical instrument. In
alternative embodiments, fiducial targets can be mounted on a
separate component that integrates with the robotic manipulator
system or medical insertion device. For example, fiducial targets
can be mounted onto a patient support, such as a table that a
patient lies on during an MRI procedure. Motion can then be easily
limited to along the confirmed axis during any contact with the
patient.
[0048] In some embodiments, the baseplate can include alignment
fiducials or other alignment markers for tracking the location of
components of the medical insertion device relative to an absolute
coordinate reference frame. The alignment fiducials provide an
"absolute" or "global" reference frame for the system to which all
real and virtual representations can be associated. For example, in
FIG. 1, baseplate 112 can include alignment fiducials 113 for
tracking the location of components of medical insertion device 100
relative to an absolute coordinate reference frame when viewing
virtual representations, such as when using an imaging system (not
shown here) to assist with a medical procedure. Alignment fiducials
113 can be associated with a variety of locations, such as the
location of medical instrument 102 or cannula 103 itself, for
correlation or registration purposes, as would be understood by
those skilled in the art. Alternatively, alignment fiducials 113
attached to specific reference locations on the baseplate 112 can
be used along with known or measured positions of the subcomponents
of medical insertion device 100 to calculate the position of
medical instrument 102 or cannula 103. These positions could be
determined, for example, using medical images, encoders associated
with the moving sub-components of the medical insertion device, or
by some other means as would be understood by those skilled in the
art. In some example embodiments, the alignment fiducial can
include MR molecular tagging, which results in an increased
conspicuity for accurate identification of the fiducial in MR
images.
[0049] Referring to FIG. 2, an alternate embodiment of the medical
insertion device is depicted. In this embodiment, linear slide
assembly 106 is folded in order to provide medical insertion device
100 in a more compact form. In this embodiment, carriage assembly
110 can support the end effector assembly 200 (described further
below) through an opening defined in front wall 104A such that end
effector assembly 200 is free of the drive assembly components.
Further, in this configuration, the medical instrument (not shown)
can be operated as a side mount, where the medical instrument is
attached to the medical insertion device 100 generally from a
direction that is perpendicular to front wall 104A. This
configuration can allow accessing a patient and exchanging medical
devices and the like simpler and safer, with less chance to
unintentionally interact with the structural and moving components
of the medical insertion device 100. The general function of the
medical insertion device 100 has not been changed in this alternate
configuration. For example, in this embodiment, the basis for
motion and positioning of medical instrument 102 is a function of
the relative position of four independent joints, mounted with two
at each end of the end effector assembly 200 and one motor to allow
motion along the end effector assembly 200 in the
insertion/retraction direction 127. With regard to the method of
tool attachment (side loading instead of rear loading), the
direction of attachment is orthogonal to the insertion axis to
reduce any chances of moving the medical instrument toward the
patient unintentionally. In addition, this direction allows for a
medical instrument changing system to be added more easily and
simplifies the design of such a medical instrument changing system.
With such an addition, the medical instrument changing system can
be constructed such that the manipulator drives to the position
where it picks up the medical instrument, and then the orthogonal
`stroke` to install the medical instrument would be short when
compared to rear loading along the insertion axis.
[0050] Referring to FIG. 2, as well as FIGS. 3, 4, 5, 6, 7A, and
7B, an end effector assembly according to embodiments of the
present invention will now be described. An end effector assembly,
generally speaking, can be an assembly that supports and at least
partially controls a medical instrument and/or cannula for
insertion into a patient along the insertion axis. In FIGS. 2, 3,
4, 5, 6, 7A and 7B, end effector assembly 200 can comprise a
cannula holder assembly which comprises cannula track 210. Cannula
track 210 can generally extend along a length of the medical
insertion device. Cannula track 210 can define fastener opening
214, through which fastener 212 can be inserted to fasten cannula
track 210 to carriage assembly 110. Cannula track 210 can be
fastened to carriage assembly 110 in any fashion known to the
skilled person, as long as the functions of the end effector
assembly according to the present invention are not substantially
impeded. Cannula holder assembly can further comprise a cannula
carriage which comprises cannula holder mount 204. End effector
assembly 200 can further comprise end effector interface 206, which
can operably interact with cannula holder mount 204, as described
further below.
[0051] Cannula holder mount 204 can be slideably mounted to cannula
track 210 by any mechanism known in the art. In the embodiment
shown, cannula track 210 can define sets of teeth, e.g., notches
211, along its opposing elongated sides. The cannula carriage can
further comprise a demobilizer. In a demobilization mode, the
demobilizer can be adapted to restrict movement of the cannula
carriage along the cannula track and in a mobilization mode allows
movement of the cannula carriage along the cannula track. In some
embodiments, the demobilizer can use a lever mechanism to engage or
disengage the notches along the sides of the cannula track to
restrict or allow movement of the cannula carriage along the
cannula track. In some embodiments, the demobilizer can be, for
example, movement lock 208, which can comprise guide plate 218 and
side tabs 216 and 220. Side tabs 216 and 220 can comprise side tab
fastening appendages 226 and 224 respectively for rotatably
fastening each side tab to cannula holder mount 204 via cannula
holder mount fastening appendages 238 and 222 respectively, each
defined on the underside of cannula holder mount 204. Side tabs 216
and 220 each also define pivots 230 and 228 respectively and pawls
240 and 242 respectively.
[0052] Guide plate 218 defines guide plate openings 232 and 234 and
fastening pivot 236. Fastening pivot is rotatably fastened to
cannula holder mount 204. Each guide plate opening 232 and 234
slidably engage with pivots 228 and 230 respectively.
[0053] Referring to FIGS. 7A and 7B, movement lock 208 is shown
assembled and fastened to cannula holder mount 204 and cannula
track 210, viewed from the underside of cannula holder mount 204
(cannula track 210 is transparent for viewing purposes). FIG. 7A
shows the configuration where movement lock 208 is in the locked
position. In the locked position, pawls 240 and 242 each engage a
first set of teeth and a second set of teeth, respectively, e.g.,
notches 211a and 211b, in order to prevent cannula holder mount 204
from sliding in the insertion direction (towards the patient when
in operation) or the retraction direction (away from the patient)
along insertion axis 127. FIG. 7B shows the configuration where
movement lock 208 is in the unlocked position. In the unlocked
position each of pawls 240 and 242 do not engage notches 211a and
211b respectively. Movement lock 208 is biased to be in the locked
position.
[0054] In some embodiments, the demobilizer can comprises a toggle
mechanism for disengaging the first pawl from the first set of
teeth when the second pawl is disengaged from the second set of
teeth, and for disengaging the second pawl from the second set of
teeth when the first pawl is disengaged from the first set of
teeth. For example, movement lock 208 can be designed such that, if
side tab 216 is moved in a manner that pawl 240 becomes disengaged
from notches 211a, then pivot 230 will move along the oblong shape
of guide plate opening 234. This movement will force guide plate
218 to pivot around fastening pivot point 236 such that the
corresponding motion of guide plate opening 232 will cause pivot
228 to move along guide plate opening 232. The movement of pivot
228 will cause side tab 220 to pivot around side tab fastening
appendage 224, which in turn can cause pawl 242 to disengage from
notches 211b. Thus, causing either of side tab 216 or 220 to
disengage from notches 211a or 211b respectively will cause the
other tab to disengage from the respective notches through the
action of guide plate 218.
[0055] Movement lock 208 can prevent cannula holder mount 204 from
moving along either direction of cannula track 210. In some
embodiments, notches 211a and 211b are not mirror images of each
other through axis 127. Rather, notches 211a are notched in the
opposite direction from notches 211b. Therefore, each of pawls 240
and 242 prevent cannula holder mount 204 from sliding along cannula
track 210 in one direction, while allowing movement in the other
direction.
[0056] In some embodiments, while pawl 240 generally prevents
motion of cannula holder mount 204 in one direction of axis 127 and
pawl 242 generally prevents motion in the opposite direction, it
will be appreciated by the skilled person that movement lock 208
generally does not allow cannula holder mount 204 to move in either
direction unless one or both pawls 240 and 242 are disengaged from
the respective notches 211a and 211b. For example, guide plate
opening 234 can be designed such that it is slightly larger than
guide plate opening 232. This has the effect that if there is only
partial movement of side tab 216 around pivot 230, only pawl 240
will disengage from notches 211a; therefore, motion will only be
possible in one direction until side tab 216 is fully depressed,
causing pawl 242 to disengage from notches 211b via action of guide
plate 218 as described above.
[0057] In some embodiments, disengaging pawls 240 and 242 from the
respective notches 211a and 211b can occur in more than one
fashion. Firstly, side tab 220 defines lever 250, which can be
manually pressed such that side tab 220 pivots around side tab
fastening appendage 224 disengages pawl 242 from notches 211b. This
would correspondingly disengage pawl 240 from notches 211a via
guide plate 218 in the manner described above. This allows cannula
holder mount 204 to be moved back and forth along cannula track 210
manually as desired.
[0058] In some embodiments, the insertion carriage can include a
demobilizer-disengaging member adapted to set the demobilizer to a
mobilization mode. In another embodiment, the end effector
interface can include a demobilizer-disengaging member adapted to
set the demobilizer to a mobilization mode. For example, another
method of disengaging pawls 240 and 242 from the respective notches
211a and 211b can involve the interaction of end effector interface
206 with side tab 216, which can further comprise ramp 244.
[0059] End effector interface 206 can be fastened to insertion
carriage 124 by screws, glue, or any other means known in the art.
End effector interface 206 can define a space through which cannula
track 210 can be disposed. End effector interface 206 can be
mechanically powered through carriage assembly 110 through means
such as a piezoelectric stepper motor housed inside the insertion
carriage 124 such that end effector interface 206 can automatically
move in either direction along cannula track 210. Other means could
be an electric motor and/or gear or drive band mechanism. End
effector interface 206 can comprise receiving members 402 and 404
and protrusion 406. Receiving members 402 and 404 can each define
receiving member openings 408 and 410 respectively. Further,
receiving members 402 and 404 can extend generally perpendicular to
insertion axis 127 and can also at least partially define mounting
tray 600. In operation, as end effector interface 206 is propelled
along cannula track 210, protrusion 406 can engage ramp 244, which
causes pawl 240 to disengage from notches 211a and allows cannula
holder mount 204 to move in an insertion direction along axis 127.
Once end effector interface 206 retreats from engagement with
cannula holder mount 204, cannula holder mount 204 becomes locked
at the location along cannula track 210 at which end effector
interface 206 left it.
[0060] As described above, ramp 244 and guide plate opening 234 can
be constructed such that only pawl 240 disengages from notches
211a, while pawl 242 remains engaged with notches 211b, when
protrusion 406 engages ramp 244. This has the function of allowing
only forward motion of cannula holder mount 204 when end effector
interface 206 moves in an insertion direction along axis 127. Due
to pawl 242 being engaged with notches 211b, this has the secondary
function of ensuring that cannula holder mount 204 does not move
backwards along axis 127 once end effector interface 206 retreats
from engagement with cannula holder mount 204.
[0061] Referring to FIGS. 8, 9, 10, 11, 12A, 12B and 12C, the
function the cannula holder mount will be further described.
Cannula holder mount 204 can be adapted to receive cannula holder
506. Cannula holder 506 comprises securing mechanism 508, to which
cannula 103 can be reversibly secured. In the embodiment shown,
securing mechanism defines securing mechanism slot 510 which can
assist in securing a cannula 103 to cannula holder 506. For
example, as shown in FIGS. 12A, 12B and 12C, cannula 103 can define
appendage 542, which can be adapted to securely engage with
securing mechanism slot 510 when cannula 103 is secured to cannula
holder 506. In the example embodiment, cannula 103 is shown in
relation to cannula holder 506 in three positions: (i) ready to be
positioned (FIG. 12A), (ii) positioned but not locked (FIG. 12B),
and (iii) locked in place (FIG. 12C). Securing mechanism 508 can be
designed to securely fit the dimensions of any cannula 103, such as
the dimensions of the ATEC.TM. cannula. When properly fitted,
cannula 103 is generally parallel to axis 127 and will travel only
on this axis as cannula holder mount 204 moves along cannula track
210. When properly fitted, cannula holder 506 ensures that the
cannula is positioned such that, for example, a needle of a vacuum
assisted biopsy (VAB) tool can pass through the hollow middle
portion of cannula 103.
[0062] Cannula holder 506 further comprises tray 514 which is
generally shaped to allow passage of medical instrument 102. Tray
514 defines tray opening 512 which generally pieces together with a
portion of cannula holder mount 204. Cannula holder 506 further
comprises cannula holder attachments 504 and 520 on the underside
of tray 514. Cannula holder attachments 504 and 520 can securely
attach through a snap-fit to mating attachments 516 and 518, which
are defined on generally opposing ends of cannula holder mount 204.
Other methods of securing cannula holder 506 to cannula holder
mount 204 will be readily apparent to the skilled person, and
include pin/socket connectors, clips, wrap-around parts, friction
fit, permanent or temporary adhesives, screws, and the like.
Attaching cannula holder 506 to cannula holder mount 204 allows
cannula 103, when secured to cannula holder 506, to move co-axially
with and be controlled by the movement of cannula holder mount
204.
[0063] According to some embodiments of the invention, cannula
holder mount 204 is not able to move without manual intervention.
Other possible mechanisms recognized by the skilled person could
involve implementing an independent actuator or motor to move
cannula holder mount 204 without the need for manual
intervention.
[0064] Referring to FIGS. 13 and 14, tool mount adaptor 800, which
can releasably attach to end effector interface 206, will be
further described according to another embodiment of the invention.
Tool mount adaptor 800 can comprise collar 802, which can be
comprised of more than one interconnecting piece. In the embodiment
shown, collar 802 is comprised of pieces 802a and 802b, which can
releasably couple to each other to form collar 802. Generally, tool
mount adaptor 800 can function to operably connect medical
instrument 102 to medical insertion device 100. Collar 802 can be
releasably secured to medical instrument 102 or cannula 103 for
attachment to mounting tray 600 of end effector interface 206. In
an embodiment of the tool mount adaptor 800, the inner diameter of
collar 802 may be, for example, about 41.8 mm. This diameter
defines the maximum diameter of tool or medical instrument 102 that
can be accommodated by the tool mount adaptor; alternately,
increasing the size of the tool mount adaptor will consequently
increase this diameter, allowing larger tools to be held at the
expense of limiting range of motion due to collisions with the
structure of the medical insertion device 100 or surrounding
structure (e.g., the imaging system or patient). Collar 802 can
attach to any suitable medical instrument, and can allow a variety
of medical instruments to be operable with medical insertion device
100. In other embodiments, collar 802 can be integrated into
medical instrument 102 for simplifying setup of medical instrument
102 for use with medical insertion device 100.
[0065] As shown in FIGS. 15A, 15B and 15C, collar 802 can be used
to mount different medical instruments to medical insertion device
100 such as a trocar tool 606 (FIG. 15A), an anesthesia tool 608
(FIG. 15B), or a biopsy tool 610 (FIG. 15C). Other medical
instruments or tools, such as needle based diagnostic or
therapeutic devices such as ablative, fibre-optic, or other
technologies, that fit within the collar 802 can be accommodated
for use with medical insertion device 100 through an appropriately
modified tool mount adaptor 800 as would be appreciated by a
skilled person. For example, in FIG. 15B, tool mount adaptor 800
can include latch 604, which can secure, or aid in securing,
anesthesia tool 608 to tool mount adaptor 800. The use of several
tool mount adaptors 800 coupled to different medical instruments
102 could allow for an entire clinical procedure or aspects of a
clinical procedure to be conducted robotically using medical
insertion device 100.
[0066] Collar 802 can include tab members 806 and 808, which
operably connect to connection ends 812 and 814, respectively.
Connection ends each define nubs 816 and 818 on their inner
surfaces. Upon connecting tool mount adaptor 800 to end effector
interface 206, tab members 806 and 808 can be depressed inwardly
generally towards each other in order to extend connection ends 812
and 814 outwardly and against the bias. Collar 802 can then be
placed in mounting tray 600 and tab members 806 and 808 can be
released, thereby allowing receiving member openings 408 and 410 to
securely receive nubs 816 and 818. The skilled person would
understand that variations are possible, for example, openings can
be defined on the connection ends while nubs are defined on the
receiving members. The skilled person would also understand that
there are other methods of securing collar 802 to mounting tray 600
including, but not limited to, a screw and threaded hole fixture
between aligned and touching parts of securing collar 802 and
mounting tray 600, or a friction fit or tongue-and-groove
construction.
[0067] In some embodiments, connection ends 812 and 814 and nubs
816 and 818 can be made, at least partially, from a resilient
material such as a thermoplastic, thermoset plastic, or a composite
material such as fibreglass or carbon fibre. In other embodiments,
connection ends 812 and 814 can include hinges and can be
spring-biased to maintain the engagement of connection ends 812 and
814 to receiving member openings 408 and 410.
[0068] As described above, mounting tray 600 can include receiving
members 402 and 404, which can comprise of multiple "fingers", and
not necessarily just single members as shown in the figures.
Furthermore, receiving members 402 and 404, may or may not conform
exactly to the shape of the medical instrument 102 and they can
extend around medical instrument 102 to varying degrees (e.g., they
are shown to extend over approximately half of the circumference of
a cylinder in the embodiment shown in the figures). The exact
dimensions of receiving members 402 and 404 will depend on the
requirements of the specific embodiment of the invention.
[0069] In another embodiment, collar 802 can include lockout tab
810, which can prevent the accidental release of collar 802 from
the mounting tray of end effector interface 206. When lockout tab
810 is in a securement mode, it can restrict the ability of an
operator from disengaging connection ends 812 and 814 by limiting
access to tab members 806 and 808. When lockout tab 810 is in
instrument changing mode, it can allow an operator to disengage
connection ends 812 and 814 by operating tab members 806 and 808.
As will be understood by the skilled person, it can be possible for
an operator to mount or remove medical instrument 102 with one
hand. For example, an operator can hold a portion of medical
instrument 102 generally near collar 802. The operator can then
turn lockout tab 810 and then depress tab members 806 and 808 with
his or her thumb and finger. Medical instrument 102 would then be
released from medical insertion device 100. The skilled person will
recognize that other means of preventing disengagement of
connection ends 812 and 814 is also possible by methods such as,
but not limited to, a cover over the entirety of operating tab
members 806 and 808 that does not allow their operation.
[0070] As will have become apparent to the skilled person, collar
802 is designed to securely attach to a medical instrument 102 in
order to allow quick fastening to medical insertion device 100. In
some embodiments, multiple tool mount adaptors 800 can be on hand,
each attached to a different medical instrument 102. This will
allow quick and secure interchangeability during a procedure on a
patient.
[0071] Tool interface feature 804 is shown as an example embodiment
of features that may be fashioned into the interior surface of tool
mount adaptor 800. Features such as tool interface feature 804 may
be constructed to ensure a secure, slip-free, and consistent
mounting of a medical instrument 102 in a specific manner, such
that the tip of medical instrument 102 will always be in a known
location relative to the end effector interface 206. It is
understood by persons skilled in the art that the exact nature of a
tool interface feature is dependent on the specific surface
features medical instrument to which the tool mount adaptor is
being designed to fit. These features can include, but would not be
limited to, the variable shape of the housing and/or grooves or
other features that consistently form part of the outer surface of
the medical instrument. In some embodiments, the medical instrument
is held securely in the tool mount adaptor such that the location
of the tip of the tool can be calculated to a high degree of
accuracy. In some embodiments, the medical instrument is held
securely in the tool mount adaptor such that the location of the
tip of the medical instrument can be calculated to a millimeter
degree of accuracy or a sub-millimeter degree of accuracy. For
example, the medical instrument is held securely in the tool mount
adaptor such that the location of the tip can be calculated to a 2
mm degree of accuracy, a 1 mm degree of accuracy, a 0.9 mm degree
of accuracy, a 0.8 mm degree of accuracy, a 0.7 mm degree of
accuracy, a 0.6 mm degree of accuracy, a 0.5 mm degree of accuracy,
a 0.4 mm degree of accuracy, a 0.3 mm degree of accuracy, a 0.2 mm
degree of accuracy or a 0.1 mm degree of accuracy. In some
embodiments, the medical instrument is held securely in the tool
mount adaptor such that the location of the tip of the medical
instrument relative to the tool mount adaptor deviates to a very
small degree. For example, in some embodiments, the medical
instrument is held securely in the tool mount adaptor such that the
location of the tip of the medical instrument relative to the tool
mount adaptor deviates less than 1 mm, less than 0.9 mm, less than
0.8 mm, less than 0.7 mm, less than 0.6 mm, less than 0.5 mm, less
than 0.4 mm, less than 0.3 mm, less than 0.2 mm, less than 0 1 mm,
less than 0.09 mm, less than 0.08 mm, less than 0.07 mm, less than
0.06 mm, less than 0.05 mm, less than 0.04 mm, less than 0.03 mm,
less than 0.02 mm or less than 0.01 mm.
[0072] The medical instrument or tool can be any instrument
generally used for insertion into a specimen, such as a patient,
and can include, but is not limited to, trocars, syringes, needles,
fibreoptic sensors, interstitial imaging devices, biopsy tools,
probes, or ablative tools. Referring to FIG. 16, medical instrument
102 can include main body 702 and elongate member 704 such as a
needle which extends from main body 702. In example embodiments,
elongate member 704 is formed from MR compatible materials such as
carbon fibre, ceramic, or titanium. Another example of the medical
instrument is a biopsy tool, such as a vacuum assisted biopsy
device, as would be understood in the art. Elongate member 704 can
also include an ablative tool such as Radio Frequency (RF)
ablation, focused ultrasound, cryotherapy, laser and other ablative
technologies that are administered within the cancerous region
causing cell destruction with minimal damage to surrounding
tissues. In some example embodiments, the medical instrument can
also include a detector such as a probe, ultrasound probe, or fiber
optic probe. The detector can also include an MRI coil to provide
higher resolution in situ imaging. In yet further example
embodiments, the medical instrument can be integrated with the end
effector interface and the tool mount adaptor to result in a
dedicated-purpose insertion device. In yet further example
embodiments, the medical instrument can include an end effector or
end effectors.
[0073] In some embodiments, medical instrument 102 can be mounted
to medical insertion device 100 generally laterally to axis 127.
Collar 802, with attached medical instrument 102, can couple to
mounting tray 600 laterally. Collar 802, having medical instrument
102 secured therein, can be attached to end effector interface 206
through a securing mechanism as described herein. By mounting
medical instrument 102 lateral to axis 127 rather than along axis
127, the chances of accidentally poking or piercing a patient can
reduced. The skilled person will recognize that the mounting of a
medical instrument 102 can also be performed generally parallel to
axis 127, or at any angle between parallel and perpendicular to
this axis as afforded by the specific embodiment of the device.
[0074] Medical instruments interfaced with the medical insertion
device can be inserted into a patient for various purposes, such as
for therapeutic or diagnostic purposes. Medical instruments can
include biopsy tools for taking tissue samples, such as vacuum
assisted biopsy (VAB) tools or devices available from ATEC.TM., or
other manufacturers of similar VAB tools or devices; ablative tools
for removing unwanted tissue, such as radio frequence (RF)
ablation, focused ultrasound, cryotherapy, laser and other ablative
technologies; detectors for determining characteristics of tissue
such as probes, ultrasound probes, or fibre optic probes, the
detectors may include an MRI coil to provide higher resolution in
situ imaging; or end effectors for general manipulation during an
operation. Medical instruments may be inserted into a patient to an
insertion depth in accordance with a particular procedure. The
insertion depth may be predetermined by an operator, or can be
determined during insertion by reference to sensors, such as force
feedback sensors for determining the type of tissue the medical
instrument has been inserted into, or imaging technologies, such
as, but not limited to, cameras, x-ray systems, ultrasound systems,
positron emission tomography (PET) systems, positron emission
mammography (PEM) systems, CT laser mammography systems, and
molecular biological imagers.
[0075] FIGS. 16, 17, 18, 19, 20, 21 and 22 show other embodiments
of the tool mount adaptor, which can be mounted to end effector
interface 206, described above, or a similar adaptor of a robotic
device that is designed to position interventional tools at a
specific location. In some embodiments, the medical instrument can
be an anesthesia tool, for example, a syringe. In FIGS. 18, 19 and
22, tool mount adaptor 800 can contain a latch 604 to hold an
off-the-shelf syringe 908. Tool mount adaptor 800 can employ
physical (i.e., mechanical) mechanisms to ensure that the
off-the-shelf syringe 908 is secured to tool mount adaptor 800.
This includes a means of keeping the off-the-shelf syringe 908 in
place laterally (e.g., a "tight fit" mould or a secondary security
latch that fits around the syringe) and along the length of the
syringe (e.g., a latch 604, or a syringe slot 906 for the flange at
the base of the off-the-shelf syringe 908, normally used to put two
fingers against and provide the required resistance against the
push of the plunger with your thumb).
[0076] In some embodiments, tool mount adaptor 800 can be
constructed so that an off-the-shelf needle 910 mounted to the
off-the-shelf syringe 908 will be aligned with a known trajectory.
When the tool mount adaptor 800 is translated in a fashion that is
co-linear with the centerline of the off-the-shelf syringe 908
(e.g., by a robotic or mechanical manipulator system such as
medical insertion device 100 along axis 127), the off-the-shelf
needle 910 can travel in a straight line along this trajectory. In
an embodiment, tool mount adaptor 800 can also mount the
off-the-shelf syringe 908 such that if (a) the syringe dimensions
are known and (b) the needle length is known, then the location of
the tip of the off-the-shelf needle 910 can be calculated to a high
degree of accuracy. Consequently, the trajectory of the tip will be
along the same path as the main body of the off-the-shelf needle
910, and, therefore, (a) the trajectory of the tip and (b) the
final placement of the full length of the off-the-shelf needle 910
can be calculated as well.
[0077] Tool mount adaptor 800 can also be adapted to depress or
retract the syringe plunger 902 of the off-the-shelf syringe 908.
In some embodiments, tool mount adaptor 800 comprises a linear
screw 912 that can interface with a drive gear 914. The drive gear
914 interfaces with another set of gears on a robotic manipulator,
for example, medical insertion device 100 such that a motor (that
is part of the robotic manipulator) can cause the syringe plunger
902 to be depressed or retracted. If the linear screw 912 does not
have a means to attach to the syringe plunger 902, then the robotic
device will only be able to depress the syringe plunger 902 (i.e.,
will only be able to expel the injectate from the syringe). If,
however, a means is provided for the linear screw 912 to couple
with the syringe plunger 902 (e.g., a snap-on clip that secures
them to each other), then the direction of rotation of the drive
gear 914, as initiated by the robotic device, will determine
whether the syringe plunger 902 is depressed (e.g., for deploying
anesthetic) or retracted (e.g., for aspirating fluid from a
cyst).
[0078] The mechanism by which the syringe plunger 902 is depressed
or retracted (e.g., the "linear screw") can be fully decoupled from
physical motion (translation or rotation) of the tool mount adaptor
itself In some embodiments of the medical insertion device and end
effector interface, an independent rotating gear actuates the drive
gear 914 on the tool mount adaptor 800. This allows the
off-the-shelf needle 910 to be positioned at a defined spatial
location, without depressing or retracting the syringe plunger 902.
It also allows the options of (a) leaving the off-the-shelf needle
910 at a known location while depressing (e.g. to inject) or
retracting (e.g., to aspirate) the syringe plunger 902; (b) moving
the off-the-shelf needle 910 while depressing or retracting the
syringe plunger 902 (e.g., to inject anesthetic along a path inside
tissue); or (c) any combination of the two, where the off-the-shelf
needle 910 traverses a defined path with or without the syringe
plunger 902 being depressed or retracted.
[0079] Referring to FIGS. 23, 24 and 25, another embodiment of the
tool mount adaptor will be described, which can mount to the end
effector interface, described above, or a similar adaptor of a
robotic device that is designed to position interventional tools at
a specific location. In some embodiments, the medical instrument
can be a vacuum assisted biopsy tool. In some embodiments, tool
mount adaptor 800 can contain "tight fit" moulds 1002 and 1004 to
secure an off-the-shelf biopsy tool to a robotic end effector.
These "tight fit" moulds 1002 and 1004 may contain internal grooves
and shoulders that interface with corresponding features on a
medical instrument to ensure a "tight fit" assembly. Alternatively,
this interface may be secured by screws, glue, or any other means
known in the art.
[0080] Tool mount adaptor 800 can be constructed so that an
off-the-shelf biopsy tool 1006 will be aligned with a known
trajectory. When the tool mount adaptor 800 is translated in a
fashion that is co-linear with the centerline of the off-the-shelf
biopsy tool 1006 (e.g., by a robotic or mechanical manipulator
system such as medical insertion device 100 along axis 127), the
off-the-shelf biopsy tool 1006 can travel in a straight line along
this trajectory. Tool mount adaptor 800 can also mount the
off-the-shelf biopsy tool 1006 such that if the length of the
biopsy tool needle is known, then the location of the tip of the
off-the-shelf biopsy tool 1006 can be calculated to a high degree
of accuracy. Consequently, the trajectory of the biopsy tool tip
will be along the same path as the main body of the off-the-shelf
biopsy tool 1006, and, therefore, (a) the trajectory of the tip and
(b) the final placement of the full length of the off-the-shelf
biopsy tool 1006 can be calculated as well.
[0081] Tool mount adaptor 800 can also be adapted to roll the
off-the-shelf biopsy tool 1006. This roll functionality may be used
to rotate the aperture of the biopsy tool around the axis of the
biopsy tool, which could enable 360.degree. of sampling. In an
embodiment, tool mount adaptor 800 comprises a drive gear
integrated into "tight fit" moulds 1002 and 1004. The drive gear on
"tight fit" moulds 1002 and 1004 interfaces with another set of
gears on a robotic manipulator, for example, medical insertion
device 100 such that a motor (that is part of the robotic
manipulator) can cause the off-the-shelf biopsy tool 1006 to be
rolled. The direction of rotation of the drive gear is controlled
by the robotic device, and will determine whether the off-the-shelf
biopsy tool 1006 is rotated clockwise or counterclockwise.
[0082] The mechanism by which the off-the-shelf biopsy tool 1006 is
rotated (i.e., the drive gear) can be fully decoupled from physical
motion (translational) of the tool mount adaptor 800 itself. In
some embodiments of the medical insertion device 100 and end
effector interface 206, an independent rotating gear actuates the
drive gear on "tight fit" moulds 1002 and 1004. This allows the
off-the-shelf biopsy tool 1006 to be positioned at a defined
spatial location without any rotational motion. It also allows the
options of leaving the off-the-shelf biopsy tool 1006 at a known
location while rotating the aperature window.
[0083] In some embodiments, there is provided a method for
facilitating insertion of a medical instrument in a patient using a
medical insertion device, the medical insertion device comprising:
(a) a frame; and (b) a carriage assembly connected to the frame
comprising: (i) a mounting arm comprising an insertion track; (ii)
an insertion carriage adapted to move along the insertion track;
and (iii) a tool mount adaptor connected to the insertion carriage,
the tool mount adaptor comprising a collar for holding a medical
instrument and a medical instrument held in the collar, wherein the
tool mount adaptor is releasably attachable to the insertion
carriage, the method comprising: moving the insertion carriage
along the insertion track in an insertion direction toward the
patient. In other embodiments of the method, the mounting arm of
the carriage assembly further comprises a cannula track parallel to
the insertion track; and the carriage assembly further comprises a
cannula carriage, wherein the cannula carriage comprises a
demobilizer, a cannula holder mount for receiving a cannula, and a
cannula held in the cannula holder mount, wherein the cannula
carriage is adapted to move along the cannula track, and the
demobilizer in a demobilization mode is adapted to restrict
movement of the cannula carriage along the cannula track and in a
mobilization mode allows movement of the cannula carriage along the
cannula track. In operation, insertion carriage 124 can move along
insertion track 122 along axis 127 toward a patient. When
protrusion 406 abuts cannula holder mount 204, movement lock 208 is
engaged as described above to unlock cannula holder mount 204 from
cannula track 210, thereby allowing insertion carriage 124 and
cannula holder mount 204 to continue along axis 127, and ultimately
insert medical instrument 102 and/or cannula 103 into the patient.
For example, medical instrument 102 can function as an introducer
for an initial insertion into the patient. When the desired
insertion depth on the patient is reached, end effector interface
206 and medical instrument 102 can retract, causing movement lock
208 to once again lock to cannula track 210, causing cannula 103 to
remain in place in the patient. Medical instrument 102 attached to
retracted tool mount adaptor 800 can then be replaced with
alternative instruments and inserted into the patient without
additional invasive insertions.
[0084] Medical instrument 102 and cannula 103 can operate in
conjunction with each other. For example, medical instrument 102
can be a trocar, which can act as a cutter. According to some
embodiments, cannula 103, sometimes called an introducer, can be
introduced to the desired site within a patient after a trocar is
used to create the initial puncture through the patient's skin.
Once cannula 103 is placed at the desired site by way of the
trocar, the trocar can removed and the cannula can be left in place
for other tools to traverse the same path. Cannula 103 can then
provide a path through which multiple interventional tools will
pass. This avoids extra punctures through the skin and additional
trajectories for different tools through the tissue. Once
retracted, the trocar can then be exchanged with a different
medical instrument, such as, but not limited to, a medical
instrument useful for endoscopy, biopsy, anesthesia, ablation,
imaging, spectroscopy, aspiration, and the like. This can allow for
a variety of procedures to be performed while minimizing the number
of invasive insertions into the patient.
[0085] Generally, the medical insertion device can be used in
conjunction with an imaging system (not shown here), such as a
magnetic resonance imaging (MRI) system, when the imaging system is
in use. Other imaging systems with which the medical insertion
device can be used include, but are not limited to, cameras, x-ray
systems, ultrasound systems, positron emission tomography (PET)
systems, single photon emission compute tomography (SPECT) systems,
optical coherence tomography (OCT) systems, optical imaging and/or
spectroscopy systems, thermal imaging systems, positron emission
mammography (PEM) systems, CT laser mammography systems, and
molecular biological imagers.
[0086] Referring to FIGS. 26A, 26B and 27, another embodiment of
the invention will be described. In some embodiments, a needle
guide 1008 is also provided. The needle guide 1008 is designed to
mount to the cannula holder mount 204 on the cannula track 210 of
the interface and move independently of the tool mount adaptor 800.
Alternatively, one skilled in the art can appreciate that the
needle guide 1008 could be constructed to interface with the
cannula holder 506 instead of (and in the same manner as) the
cannula 103 locks into the cannula holder securing mechanism 508.
In some embodiments, the needle guide 1008 may be placed near the
skin surface to guide the off-the-shelf needle 910 to a specific
entry point. A hole in the needle guide 1008 is designed to be in
the correct location such that the off-the-shelf needle 910 will
pass through it while traversing the trajectory that has already
been defined according to the design of the tool mount adaptor 800.
When the medical insertion device 100 pushes the tool mount adaptor
800 forward (via the end effector interface 206), the off-the-shelf
needle 910 consequently passes through the needle guide 1008 before
going into the underlying tissue. This needle guide 1008 (a)
provides a visual cue as to where the off-the-shelf needle 910 will
enter the skin and (b) provides mechanical support for maintaining
a straight needle path as it enters the tissue.
[0087] In some embodiments, suitable materials for the various
described assemblies, subsystems and devices can be, for example,
ceramics, thermoplastics, thermoset plastics, carbon fibre,
composites, nanoparticle composites, aluminum, titanium, or
stainless steel. In other embodiments, when the various assemblies,
subsystems and devices described herein are intended to be used
with magnetic resonance technologies, suitable materials for the
assemblies, subsystems and devices can be, for example, magnetic
resonance compatible materials. In some embodiments, MR compatible
materials can be, for example, ceramics, thermoplastics or
thermoset plastics. In other embodiments, suitable materials can
be, for example, carbon fibre, composites, nanoparticle composites,
aluminum, titanium, or stainless steel. In some embodiments, MR
compatible motors can be, for example, piezoelectric motors,
pneumatic, vacuum-actuated or hydraulic drivers. If described
devices are not intended to be MRI compatible, other materials,
such as metal components or standard inductive electrical motors,
can be suitable. The various described assemblies, subsystems and
devices can be manufactured using additive manufacturing methods.
In some embodiments, the tool mount adaptor can be manufactured by
using, for example, 3D printing. In some embodiments, for example,
3D printing can build an object or device from a series of layers,
each layer being printed directly on top of a previous layer. In
further embodiments, for example, a 3D printing model for the
object or device can be created with a computer aided design
package or via a 3D scanner. According to other embodiments, to
manufacture the object or device, the 3D printer can read the
design from a 3D printable file and can lay down successive layers
of the raw material (for example, liquid, powder, paper or sheet
material) to build the model from a series of cross sections. These
layers, which may correspond to the virtual cross sections from the
CAD model, may be joined or automatically fused to create the final
shape of the object or device. In some embodiments, for example,
the 3D printing can use lasers or electron beams to join or fuse
the layers.
[0088] Generally speaking, the invention provides for the operable
co-operation of a tool mount adaptor for securing a medical
instrument and a cannula holder for securing a cannula. The tool
mount adaptor can be constructed so that off-the-shelf tools or
custom tools will be aligned with a known trajectory. This
trajectory may be straight or angular as controlled by a robotic
manipulator, for example, medical insertion device 100. Tool mount
adaptors can also secure tools such that if the length of the tool
is known, then the location of the tip of the tool can be
calculated to a high degree of accuracy. Consequently, the
trajectory of the biopsy tool tip will be along the same path as
the main body of the tool, and, therefore, (a) the trajectory of
the tip and/or (b) the final placement of the full length of the
off-the-shelf biopsy tool can be calculated.
[0089] The tool mount adaptor can be coupled to a medical insertion
device comprising a mounting arm, an insertion track mounted on the
mounting arm, an insertion carriage adapted to be slideably
moveable along the instrument track, and a cannula track mounted on
the mounting arm, generally parallel to the insertion track. The
tool mount adaptor can be coupled to the insertion carriage and the
cannula holder can be coupled to the cannula track such that the
medical instrument and the cannula are slideably moveable along the
same axis. At least a portion of the body of the medical instrument
can be accommodated by the hollow body of the cannula. When an
operator causes the insertion carriage to move along the insertion
track in the insertion direction, for example to insert the medical
instrument into a patient, the tool mount adaptor can disengage the
cannula holder and can allow both the tool mount adaptor and the
cannula holder to proceed in the insertion direction until the
medical instrument and the cannula reach an insertion depth within
a patient. The tool mount adaptor can then be retracted, leaving
the cannula holder to remain in place. This allows an operator to
mount a different medical instrument to the medical insertion
device to perform additional tasks while not requiring additional
invasive insertions into a patient.
[0090] Variations may be made to the medical insertion device in
example embodiments. For example, in some example embodiments, an
insertion mechanism may be used to move the entire linear slide
assembly 106 in the insertion direction 127 to provide the
insertion step (rather than from the insertion track 122). In some
additional embodiments, some medical instruments 102 may include
their own insertion or injection mechanism, which may be automated
or manually controllable by a mechanism for insertion.
[0091] Specific examples of the assembly and components have been
described for illustrative purposes. These are only examples. The
technology provided can be applied to systems other than the given
examples. Those of skill in the art will recognize certain
modifications, permutations, additions and sub-combinations
thereof. It is therefore intended that the following appended
claims and claims hereafter introduced are interpreted to include
all such modifications, permutations, additions and
sub-combinations.
* * * * *